Stay Mobile in Labour
One of my biggest passions is supporting women with complications to have active, mobile and positive birth experiences. Some women will chose to birth at home with no intervention, whilst others will make the decision to birth in hospital. Perhaps they have chosen to accept an induction of labour, or after considering the evidence they feel that continuous monitoring of their baby's heart is the right course of action.
Whatever your choice, it is vital that the decision is informed and you have had the chance to consider relevant evidence, apply it to your own unique situation and discuss the benefits and potential complications of intervention vs no intervention with an obstetrician.
Wherever and however you birth, if you have complications or not, it is important to stay upright and mobile during active labour. Simply put, this allows your pelvis to open so your baby has the maximum amount of room to navigate its way out into this world, gravity supports the process of birthing and the pyhsiology of birth sees a woman naturally adopting positions that are comfortable, reducing the intensity of birth and allowing your endorphins to multiply.
At home it is relatively easy to achieve freedom of movement, because your instincts will take you to the space in your home that feels right at any given moment. This could be in the bathroom, on the toilet, up and down the stairs, leaning against the kitchen worktop, hiding behind the sofa, using the soft cushioning of your carpet to adopt an all fours position.
But in hospital you are restricted. Less so in a birth centre or midwife led unit because the space has been designed for you to stay mobile in labour and support the physiological birthing process. However mobility can be limited in an obstetric unit by the use of medical equipment, small rooms, the dominance of beds, no en-suite, lack of equipment to support mobility and the culture/ethos of a medicalised institute. It doesn't matter what complications you have, or what procedures you consent to, birth is STILL a physiological process.
So how do you stay mobile in labour in an environment that limits mobility? My biggest piece of advice is to get off the bed. The Royal College of Midwives ran a campaign a few years ago and created a fabulous image (below) to give you ideas on how to stay mobile in labour. Get creative and find what is comfortable in the moment.
As soon as you push the bed out of the way, you create lots more floor space. Ask for:
a birth ball to sit on or lean against
a mat or pillows to kneel on
a birth stool
wireless monitoring (telemetry) so you can use the pool or shower or have greater freedom of movement
the bed to be raised so you can lean against it
play your music so you can dance/sway
take a rebozo so you can rock/be supported by your partner
Do not let a hospital room or medical equipment limit your mobility. In my experience, the biggest restrictions to mobility are continuous electronic fetal monitoring (CEFM) and epidurals. Make informed decisions that are right for you, rest when you need to and know that there is often another way...
Here are some ideas for you to look into further that are not really in the scope of this blog:
Telemetry is usually available in obstetric units and is the best option for helping you to stay mobile in labour when you choose CEFM. However, there is often only one or two available in any unit.
The Fetal Scalp Electrode definitely has it's place for CEFM when your baby's heart rate cannot be monitored effectively and you want to stay mobile in labour, but use with caution.
You may wish to consider short periods of CEFM mixed with intermittent monitoring.
If you choose an epidural, the Roll-Over is the best technique for avoiding all the complications associated with a static position. You can also use this in a labour that is moving slowly.
My role as an independent midwife sees me advocating for and supporting women who find their obstetrician or local hospital is not supporting their informed choices. I love what I do. You can read more about how I support individual in their birthing journey on my services page.